Care Coordinator

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Take full ownership of assigned cases, ensuring thorough management of the patient journey from HUB enrollment through post-fill follow-up.

• Act as the primary contact for patients, caregivers, and healthcare providers regarding reimbursement and access support.

• Address inquiries from patients and caregivers regarding access and coverage.

• Facilitate access for healthcare providers and enrolled patients prescribed PDPA or VFM products.

• Conduct discussions on Summary of Benefits for HUB-enrolled patients.

• Gather missing Patient Enrollment Form data and confirm testing, voucher, and Interim Care choices.

• Clarify out-of-pocket expenses, deductibles, copay alternatives, reimbursement programs, maximizers, and accumulators.

• Validate product and baseline-test coverage through PBM and major medical insurance for VFM.

• Oversee prior authorization submissions, verification processes, and appeals assistance.

• Perform benefits investigation and verification calls with payers and patients.

• Convey coverage, cost, authorization, appeal, Interim Care, and baseline-assessment criteria.

• Organize, reschedule, and confirm patient appointments with patients, providers, and vendors.

• Coordinate patient assessment tests with IQVIA/MDX.

• Manage administrative requirements and deadlines related to Interim Care.

• Verify voucher eligibility and manage voucher shipments.

• Maintain access to the copay portal and assist eligible patients in securing copay cards.

• Oversee copay eligibility attestation and confirm copay-card functionality post-fill.

• Manage voucher, paid prescription, and Interim Care fills in Polaris.

• Reach out to patients 10 and 45 days after prescription fulfillment to address logistical or financial inquiries.

• Handle case types in Polaris through texting, faxing, and prescription-triage functionalities.

• Review prior authorization, appeal, and PEF documentation for accuracy.

• Share and manage cases with HUB partners.

• Collaborate with Pfizer colleagues, the Patient Support Program, and HUB staff to resolve case-related issues.

• Document every HCP and patient call with real-time case comments.

• Utilize Kite works encrypted email and manage DocuSign consent collection.

• Report adverse events in accordance with company protocols.

• Communicate access options in compliance using Brand RC-approved materials.

• Uphold confidentiality and adhere to company compliance standards.

• Collaborate cross-functionally with internal and external colleagues to enhance patient access.

• Connect customer insights to approved resources that address access barriers.

• Build trust through compliant follow-up and expertise in the access journey.

⛳️ Requirements

• Bachelor's degree (B.S. or B.A.).

• Over 8 years of experience in pharmaceutical or related customer-facing roles/functions.

• Minimum of 6 months as a FRM, PAC, FAS, or similar position in access and reimbursement, including experience with the Polaris CRM System.

• Working knowledge of Polaris, with competencies in case management, documentation, prescription triage, and understanding of PA, appeal, and PEF documentation.

• Proven ability to communicate effectively with patients, providers, and cross-functional colleagues.

• Experience in conducting benefit investigations and verifications directly with payers.

• Familiarity with prior authorization and appeals processes.

• Knowledge of copay programs, maximizers and accumulators, vouchers, and interim care programs.

• Capability to manage a large volume of concurrent cases with meticulous documentation and follow-through.

• Ability to fulfill adverse event reporting responsibilities in a role involving frequent direct patient interaction.

• Strong grasp of reimbursement, government payment systems, specialty pharmacy networks, co-pay assistance programs, and the specialty medication domain.

• Appropriate and compliant communication and collaboration with cross-functional field-based colleagues.

• Alignment with HQ stakeholders to support patient access initiatives.

• Flexibility to work across various time zones as required.

• Willingness to travel approximately 10% to 20% of the time.

• Must be authorized to work in the U.S. for any employer.

• U.S. work visa sponsorship is not available now or in the future.

• This position necessitates permanent work authorization in the United States.

• Preferred: experience in a patient/customer-facing role focused on access and reimbursement education.

• Preferred: experience working with a HUB.

• Preferred: experience with Kite works or a similar encrypted email platform, DocuSign, and copay portal management.

• Preferred: experience coordinating with third-party vendors for patient assessment, testing, or specialty pharmacy logistics.

• Preferred: experience supporting Interim Care, free goods, or bridge programs.

• Preferred: familiarity with both pharmacy benefit and major medical benefit coverage pathways.

• Excellent written and verbal communication abilities.

• Exceptional relationship-building skills, particularly with elderly populations.

• Strong attention to detail and organizational capabilities.

• Outstanding critical thinking skills.

• Understanding of specialty pharmaceuticals and patient journeys.

• Adherence to regulatory and compliance standards.

🏝️ Benefits

• Bonus target of 20.0% of base salary through Pfizer’s Global Performance Plan.

• Eligibility to participate in Pfizer’s share-based long-term incentive program.

• 401(k) plan with Pfizer matching contributions.

• Additional Pfizer Retirement Savings Contribution.

• Paid vacation, holidays, and personal days.

• Paid caregiver/parental leave and medical leave.

• Comprehensive medical, prescription drug, dental, and vision coverage.

• Relocation assistance may be available based on business needs and/or eligibility.